Tillery, NC
Understanding Health
and Wellness Needs
A Community’s Perspective
The Tillery Community
CCT Philosophy of Health Care
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Concerned Citizens of Tillery (CCT) believes that
the conditions necessary for good health - including
recreational facilities, excellent schools and medical
facilities, lifelong learning opportunities, nutritious
food, and economic development - will not be
granted by outside institutions, but will be created by
a strong community working in equal partnership
with other organizations and institutions. (ECU OT
and SW, AWHC, People’s Health Clinic)
Understanding the Community
Why the interest?
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Comin’ Home
Aging in place
Community support
Contextually and culturally embodied
Community built practice
Door to Door Survey
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SF-12 and environmental questions
104 participants (100 in 1996)
Students from ECU and UNC-CH
Assess the health related quality of life of
residents of those in 5 mile radius of Tillery
Community Center
Finding out about the Community:
Student Perspectives
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Hardworking people
Self Sufficient
Spiritual
Family and Community
Oriented
Friendly
Welcoming
Warm
Gender
42 males (34), 61 females (34)
Race
81 African Americans (89)
15 Caucasians (11 C + others)
Employment
Heating
67 not employed
36 gas (20), 26 central, 7 wood
(7)
Cooling
41 AC, 40 central, 9 fans
Smell mildew or mold 89 no, 14 yes
Home flooded
80 no, 23 yes
Smells inside home
79 no, 21 yes
from industry
Smells outside home
53 no, 47 yes
from industry
General Health
Health limitations for
moderate activities
Health limitations for stair
climbing
Daily activities
accomplished less than like
due to physical health
Limited in kind of activities
due to physical health
14 excellent (16), 24 very good (12),
33 good (38), 26 fair (29), 7 poor (5)
16 a lot (18), 23 a little (26), 64 not
at all (57)
21 a lot (17), 25 a little (26), 54 not
at all (57)
9 all of the time, 12 most of the time,
22 some of the time, 18 a little of the
time, 42 none of the time
5 all of the time, 10 most of the time,
14 some of the time, 20 a little of the
time, 52 none of the time
Daily activities
3 all of the time, 12 most of the time,
accomplished less than like 16 some of the time, 14 a little of the
due to emotional problems time, 57 none of the time
Daily activities less carefully
than usual due to emotional
problems
2 all of the time, 6 most of the time, 14
some of the time, 11 a little of the time, 67
none of the time
Pain interfere with daily
activities
46 not at all (27), 21 a little (29), 14
moderately (8), 14 quite a bit (25), 7
extremely (10)
Felt calm and peaceful
27 all of the time (14), 45 most of the time
(51), 15 some of the time (13), 14 a little of
the time (17), 2 none of the time (5)
A lot of energy
18 all of the time (11), 36 most of the time
(43), 25 some of the time (32), 15 a little of
the time (11), 9 none of the time (3)
Downhearted and depressed
3 all of the time (1), 2 most of the time (8),
18 some of the time (14), 22 a little of the
time (28), 59 none of the time (49)
Physical and emotional health
interfered with social activities
5 all of the time (1), 2 most of the time (5),
14 some of the time (5), 19 a little of the
time (11), 64 none of the time (76)
Community Quality of Life
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Community Needs Assessment—A focus group study
provided the following description of the community
quality of life: Everyone has a hand in making the
community work, Together like one big family, We’ll
all come back to Tillery, Go back to the old values or
we’re lost, We need things that complement the
community, The land is power, I have a different view
of white people and black people working together
The Road to Wellness: The Need
for Interprofessional Practice
Wellness Needs
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Wellness Group—A five week wellness program
focused on physical activities, nutrition, social
support and safety. What did the occupational therapy
wellness group mean to its participants? Data analysis
yielded five themes: fellowship through togetherness,
learning new things and education, a different outlook
on well-being, having fun, and leadership. OT and
Social Work
Home based services--OT and Social Work
Evaluation of Individual Needs,
Interests, and Goals
Planning Group Goals and
Activities
Link to Environmental and Social
Justice Issues
Philosophy of Health Care
History of Tillery
Impact of history, race,
gender,
and socioeconomic
status
Occupational Justice
Issues
Role of the Environment in Shaping
Practice
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Interpersonal
Physical (manmade and natural)
Societal (economic)
Cultural
Temporal
Funding
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Learn and Serve Grant
(1996-2002)
National Environmental
Health Sciences Institute
Grant (2004-2007)
Personal Donations
In-kind contributions from
OT ECU Department
Conditions Commonly Addressed
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Repetitive Stress, Work-Related Injuries
Diabetes
Obesity
Metabolic Disease (cardiac, Hypertension, CVA)
Arthritis
Orthopedic Problems
Low vision
Depression
Asthma
Favorite Activities
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Physical – parachute games, the Gospel Slide
dance, and Tai Chi; healthy food preparation
(banana bread, trailmix, veggie pizzas)
Cognitive – table games, Nutrition Jeopardy
and Concentration
Emotional – collages, scrapbooking, and craft
projects
Spiritual – groups end with a group prayer
circle
Outcomes for Participants
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Occupational performance
Client satisfaction
Role competence
Health and wellness
Prevention
Quality of life
Indirect Skills Learned by Students
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Client-centered care
Being a change agent in the system
Accessing resources
Cultural competency
Independent thinking and acting
Collaboration and consultation